The remarkable medical lineage of the Monro family: contributions of Alexander primus, secundus, and tertius

Abstract

Among the families that have influenced the development of modern medicine into what it is today, the Monro lineage stands as one of the most notable. Alexander Monro primus (1697-1767) was the first of 3 generations with the same name, a dynasty that spanned 126 years occupying the Chair of Anatomy one after the other at the University of Edinburgh. After becoming Professor of Anatomy at the University of Edinburgh in 1719, Monro primus played a principal role in the establishment of the University of Edinburgh School of Medicine and the Edinburgh Royal Infirmary. In 1726, he published The Anatomy of the Humane Bones, of which 8 editions were printed during his lifetime. His son, Alexander Monro secundus (1733-1817), arguably the most notable of the 3 men, succeeded him as Professor of Anatomy. A highly regarded lecturer and anatomist, Monro secundus studied under many great physicians, including William Hunter and Johann Friedrich Meckel the Elder, and was also teacher to other well-known figures at the time, such as Joseph Black and Thomas Trotter. His most notable contributions include his work with the lymphatic system, the interventricular foramen (of Monro), and the Monro-Kellie doctrine. Alexander Monro tertius (1773-1859), the last of the dynasty, also succeeded his father as Professor of Anatomy. His work included insights into abdominal aortic aneurysms and the anatomy of the genitourinary system. The prominent association of the Monro family with the University of Edinburgh and the effects of a tenured professorship under the concept of "Ad vitam aut culpam" over successive generations are also described. To the best of the authors' knowledge, this historical review of the Monro family is among the few published in neurosurgical literature. A vivid historical overview of the medical contributions of the most famous and influential dynasty of physicians in Edinburgh at that time is provided, with relevant excerpts from original publications.

A critical appraisal of Monro's erroneous description of the cerebral interventricular foramina: Age‐related magnetic resonance imaging spatial morphometry and a proposed new terminology

“…Alexander Monro secundus (1733–1817) was an extraordinary anatomist and a successful lecturer, having held the Chair of Medicine, Anatomy, and Surgery at the University of Edinburgh for almost five decades of his academic career (Patel et al, ; Sharp, ; Tubbs et al, ; Wu et al, ). His most significant works included the anatomic descriptions of the interventricular foramen, and of the physiological Monro–Kellie doctrine.…”

“…There, he describes: “The lower regions of the ventricles…are not partitioned from each other by the septum but come together in a sinus (the third ventricle) lying under the body formed like an arch (fornix); this space extends directly downwards as a prominent channel through the substance of the brain into a funnel or basin formed by a thin membrane of that shape (the infundibular recess).” Vesalius probably had the correct idea that the lateral ventricles and third ventricle indeed had a communication but he was inaccurate in his descriptions. Adrian van der Spigelius (1578–1625) in his writings offered no new knowledge on the earlier descriptions by Vesalius (Wu et al, ).…”

“…As the minimum diameter of FoM was perpendicular to its superomedial border (body of fornix), and the foramen was oval in shape, the lumen of FoM was oriented almost vertically (Figure 7). (Patel et al, 2018;Sharp, 1961;Tubbs et al, 2014;Wu et al, 2012). His most significant works included the anatomic descriptions of the interventricular foramen, and of the physiological Monro-Kellie doctrine.…”

“…Vesalius probably had the correct idea that the lateral ventricles and third ventricle indeed had a communication but he was inaccurate in his descriptions. Adrian van der Spigelius (1578-1625) in his writings offered no new knowledge on the earlier descriptions by Vesalius (Wu et al, 2012).…”

The foramen of Monro: a review of its anatomy, history, pathology, and surgery

“…Together they held the chair of anatomy at the University of Edinburgh for 126 years [17]. Monro secundus recorded detailed descriptions and illustrations regarding the communication between the lateral and third ventricles of the brain as well as describing changes seen in hydrocephalus.…”